17 Techniques To Treat And Prevent Diverticulosis

Once upon a time—say, before 1900—diverticulosis was just another of the many “rare” medical conditions that doctors had heard about but seldom had seen. Even today, diverticulosis is rare in Third World countries. But not in the United States, land of the Big Mac. Studies indicate that more than half of all Americans over the age of 60 have diverticulosis—characterized by tiny, grapelike pouches or sacs (diverticula) along the outer wall of the colon. Almost everyone over age 80 has the condition.

These pouches show up on x-rays, but many people never have this area x-rayed and don’t even know that they have the condition, says Samuel Klein, MD. Of those who do have diverticulosis, Klein says, only about 10% will ever progress to diverticulitis—a painful inflammation that can become serious. So having diverticulosis does not mean that you’re destined for severe pain or a hospital stay. Fortunately, you can take an active role in treating and preventing diverticulosis, and avoiding the pain of diverticulitis. Here’s what our experts suggest.

Bulk Up On Fiber

“Diverticulosis is a problem that is acquired,” says surgeon Paul Williamson, MD. “It’s come about with the advance of processed foods—foods that are low in fiber.” The average American gets about 16 grams of fiber daily, which is not enough. According to health authorities like the American Dietetic Association, our optimal fiber needs are between 25 and 30 grams every day. This may sound like a lot—but it does a lot of good. (Here's 4 things that happen when you don't get enough fiber.)

Fiber helps the colon expand when eliminating waste. Fiber also draws water into the stool, making bowel movements smoother. Whole wheat bread (check the label to be sure) and all-bran cereals are excellent sources of bran fiber, which appears to be the most effective type of fiber in preventing diverticulosis. Sprinkling raw bran on your foods is also an option. Vegetables and fruits are other good sources of fiber, says Klein. Fruit and vegetable juices contain very little fiber, however, so reach for an apple instead of its juice.

Try To Relax

Research published in the British Journal of Surgery showed that people with diverticulosis who scored high on an anxiety test were more likely to have pain. Lin Chang, MD, suggests that a regular relaxation practice could help. “Patients with chronic or severe gastrointestinal woes tend to have more anxiety and stress,” she says. “Behavioral techniques like relaxation training can decrease symptoms. Calming breaths help regulate the nervous system and relax the digestive tract.” When you are having abdominal discomfort, focus on how your lower belly expands as you inhale for a count of 4 and moves back in as you exhale. Do this twice daily for 15 minutes—or more often, if you find it helpful. You may also want to take a gentle yoga class or follow a yoga video two or three times a week. The breathing is similar, and the low-impact physical activity will help you digestive activity.

Eat Highly Processed Foods In Moderation

This is good general-health advice, but it also applies to treating diverticulosis. If you eat a lot of low-fiber processed foods, says Klein, you won’t have room to eat the high-fiber foods you need. (Try these 23 ways to eat clean.)

Don't Say “So Long” To Seeds

Until recently, many doctors told their patients to avoid tomatoes, strawberries, and other foods with small seeds. They believed that the seeds could lodge in the diverticula and trigger inflammation. Today, this is a controversial point among doctors. The National Institutes of Health says that there’s no evidence to support the ban on seeds and that many of these foods are good sources of fiber. So go pick that tomato from your garden.

Increase Your Fiber Intake Slowly

Take 6 to 8 weeks to gradually increase your fiber intake to the recommended 30 to 35 grams each day, Klein suggests. “You need time for your digestive system to adapt.” You can expect bloating and gas in the first few weeks. But most people will get over this.

If You Can't Get Enough Fiber In Your Diet, Take A Supplement

The best are psyllium seed supplements (such as Metamucil).

Don't Use Suppositories

While they may offer a quick fix, suppositories aren’t the best choice for stimulating bowel movements. “Your system can get addicted to them,” Klein explains. “And then it becomes a vicious cycle—you need more suppositories.”

Drink Lots Of Liquids

“Drink six to eight glasses of water a day,” advises Klein, adding that the liquid is an important partner to fiber in combating constipation, which is associated with diverticulosis. Straining during a bowel movement tends to expand the diverticula through the walls of the colon, making the problematic pockets bigger. (Bored with plain water? Try one of these 25 sassy water recipes.)

Go When You Have To Go

If you don’t yield to nature’s call, you defeat the purpose of adding more fiber to your diet and drinking more liquids. “Don’t suppress the need to move your bowel,” Williamson advises.

Soothe Your Pain With Heat

To relieve tenderness or cramping, hold a heating pad against the left side of your abdomen.

Apply A Little Pressure

Steven Tan, MD, recommends this ancient healing art to encourage natural, normal digestive system activity, easing constipation that can make diverticulosis worse. “Animal studies suggest that acupuncture may spur contractions in the colon, moving your bowel,” he says. “If your episode is minor, you could be helped by a single treatment; chronic sufferers may need about 10. Acupressure may help, too.” To try acupressure for constipation, it takes only two fingers and less than 2 minutes. Using your index and middle fingers, apply firm pressure on the outside of your lower leg, about 3 inches below the kneecap. Press in firmly for 5 seconds and then release for 10 seconds. Repeat five times. To find an acupuncturist for more treatment, visit www.aaaomonline.org, the Web site for the American Association of Acupuncture and Oriental Medicine, to search for an acupuncturist near you.

Look For A Pattern

Take It Easy With Ibuprofen And Acetaminophen

Avoid high doses of ibuprofen, a common painkiller that is known as a nonsteroidal anti-inflammatory drug (NSAID). Regular and consistent use of acetaminophen is also associated with increased symptoms of diverticular disease. One study of more than 35,000 men found that those who took NSAIDs or acetaminophen at least two times a week were twice as likely to develop diverticular disease as men who didn’t take the drugs regularly. NSAIDs inhibit prostaglandins, fatty acids that protect the cells in the intestinal tract.

Diverticulitis Cures From The Kitchen

This homemade remedy for constipation can be beneficial for anyone who wants to get more fiber: Mix 1/2 cup of unprocessed bran, 1/2 cup of applesauce, and 1/3 cup of prune juice. Refrigerate. Eat 2 to 3 tablespoons of the mixture after dinner, then drink a full glass of water. If you need to, you can increase your dose to 3 to 4 tablespoons. Whole prunes, prune juice, and herbal teas are also very effective natural laxatives. Specially formulated teas can be found in most health food stores.

Best Fiber-Boosting Foods

You know that getting enough fiber in your diet (30 to 35 grams daily) is the most important thing you can do to treat and prevent diverticulosis. But what you may not know is how much fiber is in the recommended high-fiber foods or how to inject more fiber into your diet without sitting down to a bowl of raw bran. Here are some of the top foods that can help you reach your fiber gram goal:

1 medium apple with skin = 3.3 grams

1 whole wheat English muffin = 4.4 grams

1/2 cup of green peas = 4.4 grams

1 medium sweet potato with skin = 4.8 grams

1/2 cup of black beans = 7.5 grams

1/2 cup of navy beans = 9.5 grams

1/2 cup of All-Bran cereal = 9.6 grams

When To Call A Doctor About Your Diverticulitis

If you live long enough, chances are you will get diverticulosis. Even so, odds are you won’t get diverticulitis —a painful inflammation that is potentially serious. Still, you should be aware of the warning signs. Fever, tenderness, or pain in the lower left abdominal region are good indicators that diverticulosis has advanced to diverticulitis, according to the National Digestive Diseases Information Clearinghouse. This change shouldn’t be taken lightly. Diverticulitis can lead to infection or bleeding. You should call your doctor any time you see blood after a bowel movement. And if you’ve been diagnosed with diverticulosis and develop left-sided belly pain that doesn’t go away, you should do the same. If you have an infection, it can be treated with antibiotics. For something more serious, like a tear, your doctor can determine the right plan of care.

Panel Of Advisors

Lin Chang, MD, is codirector of the Center for Neurovisceral Sciences and Women's Health at UCLA in Los Angeles.

Samuel Klein, MD, is a William H. Danforth Professor of Medicine and Nutritional Science and director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis.

Steven Tan, MD, is chairman of the California State Board of Acupuncture in Beverly Hills.

Paul Williamson, MD, is a clinical associate professor of surgery at the University of Florida in Gainesville and a colon and rectal surgeon in Orlando.

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